Division of Vascular and Endovascular Surgery, New York University School of Medicine, New York, NY 10016, USA.
J Vasc Surg. 2012 Jun;55(6):1618-22. doi: 10.1016/j.jvs.2011.12.054. Epub 2012 Feb 15.
The objective of this study was to review a single-institution contemporary experience with extracranial aneurysms of the carotid artery.
A retrospective review was conducted of patients evaluated for an aneurysm of the extracranial carotid artery from 2005 to 2010. Demographics, presentation, and operative management were reviewed. The mean follow-up was 22 months (range, 1-58 months).
Over the study period, 16 aneurysms and pseudoaneurysms were identified in 15 patients. Of these, 14 aneurysms (in six men and eight women with mean age of 63 years) underwent surgical repair. The mean aneurysm size was 2.45 cm (range, 0.8-5 cm). One aneurysm (7.1%) was associated with neurologic symptoms, and 13 were asymptomatic. The underlying etiology was trauma in five (35.7%), prior carotid endarterectomy in five (35.7%), and degenerative atherosclerosis in four (28.6%). Aneurysms were isolated to the common carotid artery in six (42.9%), internal carotid artery in five (35.7%), and carotid bifurcation in three (21.4%). Five patients underwent aneurysmectomy with primary repair, seven underwent repair with an interposition graft, one required an innominate to common carotid artery bypass, and one patient had a plication and patch angioplasty. No mortalities or neurologic events were documented within 30 days. One patient had transient cranial nerve palsy. One patient required reintervention at 4 months for stenosis of the bypass graft, and one patient died at 10 months from an unrelated condition. There were no neurologic events on follow-up.
Carotid artery aneurysms and pseudoaneurysms are uncommon and usually asymptomatic. Prior trauma and carotid surgery were common etiologies. The location of the aneurysms was equally distributed between the internal and common carotid arteries. Surgical repair was safe and effective with no significant morbidity or mortality and good midterm stroke prevention.
本研究的目的是回顾单一机构的颈外动脉外膜瘤的当代经验。
对 2005 年至 2010 年评估颈外颈动脉动脉瘤的患者进行回顾性回顾。审查了人口统计学，表现和手术管理。平均随访时间为 22 个月（范围为 1-58 个月）。
在研究期间，在 15 名患者中发现了 16 个动脉瘤和假性动脉瘤。其中，14 个动脉瘤（6 名男性和 8 名女性，平均年龄为 63 岁）接受了手术修复。平均动脉瘤大小为 2.45 厘米（范围为 0.8-5 厘米）。一个动脉瘤（7.1%）与神经症状有关，13 个为无症状。潜在病因是创伤 5 例（35.7%），先前的颈动脉内膜切除术 5 例（35.7%），退行性动脉粥样硬化 4 例（28.6%）。动脉瘤孤立于颈总动脉 6 例（42.9%），颈内动脉 5 例（35.7%），颈动脉分叉 3 例（21.4%）。5 例患者行动脉瘤切除术加原发性修复，7 例行带间置移植物修复，1 例行无名动脉至颈总动脉旁路移植术，1 例行修补和补片血管成形术。术后 30 天内无死亡或神经事件。1 例患者出现短暂性颅神经麻痹。1 例患者在 4 个月时因旁路移植术狭窄而再次介入，1 例患者在 10 个月时死于无关疾病。随访时无神经事件。
颈外动脉动脉瘤和假性动脉瘤少见且通常无症状。先前的创伤和颈动脉手术是常见的病因。动脉瘤的位置在颈内和颈总动脉之间分布均匀。手术修复安全有效，无明显发病率和死亡率，中期卒中预防效果良好。
